The application of civil commitment law and practices to a case of delusional disorder: a cross-national comparison of legal approaches in the United States and the United Kingdom

Legal approaches to civil commitment in the United States and the United Kingdom are compared. A concise overview of the historical evolution of civil commitment in both countries precedes a discussion of the present scheme of commitment standards in each system. These current standards in U.S. and U.K. jurisdictions are then applied to a hypothetical case of delusional disorder. A discussion of the constructive use of civil commitment in patients with delusional disorder who may be dangerous focuses on its value as a preventive measure against potential harm to self or others, as well as the pros and cons of coercive assessment and treatment. Despite the many differences in approach to commitment, the authors concur that in both countries the patient with delusional disorder was committable before the commission of a serious criminal offense.     

Physician decision making and cardiac risk: effects of knowledge, risk perception, risk tolerance, and fuzzy processing

Despite training, professionals sometimes make serious errors in risky decision making. The authors investigated judgments and decisions for 9 hypothetical patients at 3 levels of cardiac risk, comparing student and physician groups varying in domain-specific knowledge. Decisions were examined regarding whether they deviated from guidelines, how risk perceptions and risk tolerances determined decisions, and how the latter differed for knowledge groups. More knowledgeable professionals were better at discriminating levels of risk according to external correspondence criteria but committed similar errors in disjunctive probability judgments, violating internal coherence criteria. Also, higher knowledge groups relied on fewer dimensions of information than did lower knowledge groups. Consistent with fuzzy-trace theory, experts achieved better discrimination by processing less information and made sharper all-or-none distinctions among decision categories.     

Crossmodal links between audition and touch in covert endogenous spatial attention

We report three experiments designed to investigate the nature of any crossmodal links between audition and touch in sustained endogenous covert spatial attention, using the orthogonal spatial cuing paradigm. Participants discriminated the elevation (up vs. down) of auditory and tactile targets presented to either the left or the right of fixation. In Experiment 1, targets were expected on a particular side in just one modality; the results demonstrated that the participants could spatially shift their attention independently in both audition and touch. Experiment 2 demonstrated that when the participants were informed that targets were more likely to be on one side for both modalities, elevation judgments were faster on that side in both audition and touch. The participants were also able to "split" their auditory and tactile attention, albeit at some cost, when targets in the two modalities were expected on opposite sides. Similar results were also reported in Experiment 3 when participants adopted a crossed-hands posture, thus revealing that crossmodal links in audiotactile attention operate on a representation of space that is updated following posture change. These results are discussed in relation to previous findings regarding crossmodal links in audiovisual and visuotactile covert spatial attentional orienting.     

Weekly variations in performance on a token economy psychiatric ward

Seven types of behavior of thirteen chronic schizophrenic female patients, who were transferred to an existing male token economy ward, were rated during four experimental phases. During Conditions I and III the patients were given a token allowance in the morning on a noncontingent basis. During Conditions II and IV tokens were paid on a contingent basis; that is, the patients received tokens commensurate with their behavior ratings. Their ratings were higher during Conditions II and IV than during Conditions I and III. The results supported the expectation that the contingent tokens were controlling the behavior of the patients.     

Stress and Coping as Determinants of Adolescent Smoking Behavior1

Relationships between perceived stress, coping, and smoking behavior were examined both cross-sectionally and prospectively in a large sample of English adolescents recruited from secondary schools in East Sussex. Significant cross-sectional and prospective associations are reported between smoking behavior and perceived stress, “cathartic” coping, and perception of smoking as a coping resource. The hypothesis that female adolescents smoke more than do males because they perceive more stress in their lives and cope with it differently was not supported.     

Personal Resources and the Social Distribution of Depression

This paper addresses the hypothesis that gender, age, marital status, and SES matter for depression partly because of associated differences in the availability and/or impact of the personal resources of mastery and self-esteem. It is argued that findings indicating that the social distributions of these resources complement those for depression would provide preliminary support for this hypothesis. Based on a large urban community sample (n = 1,390), our findings fail to support the availability hypothesis in relation to marital status, provide only modest support in reference to age and gender, but yield compelling support in relation to socioeconomic status (SES). Indeed, variations in the availability of these resources, especially mastery, provide a largely, if not entirely, adequate explanation for the SES–depressive symptoms relationship and accounts for nearly half of the SES–Major Depressive Disorder relationship. Although the significance of mastery was more pronounced among women and unmarried persons, such differences did not contribute to understanding observed gender or marital status variations in depression.